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Diabet Med . SARS-CoV-2 as a Potential Cause of Type 1 Diabetes Facilitated by Spike Protein Receptor Binding Domain Attachment to Human Islet Cells

tetano

Editor, Senior Moderator
Diabet Med


. 2021 May 27;e14608.
doi: 10.1111/dme.14608. Online ahead of print.
SARS-CoV-2 as a Potential Cause of Type 1 Diabetes Facilitated by Spike Protein Receptor Binding Domain Attachment to Human Islet Cells: An Illustrative Case Study and Experimental Data


Nisha Venkatesh[SUP] 1 2 [/SUP], Natalie Astbury[SUP] 2 3 [/SUP], Merlin C Thomas[SUP] 4 [/SUP], Carlos J Rosado[SUP] 4 [/SUP], Evan Pappas[SUP] 5 [/SUP], Balasubramanian Krishnamurthy[SUP] 1 2 5 [/SUP], Richard J MacIsaac[SUP] 1 2 [/SUP], Thomas W H Kay[SUP] 1 5 [/SUP], Helen E Thomas[SUP] 1 5 [/SUP], David N O'Neal[SUP] 1 2 3 [/SUP]



Affiliations

Abstract

Aims: To report Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, responsible for Coronavirus Disease 2019 (COVID-19), as a possible cause for type 1 diabetes by providing an illustrative clinical case of a man aged 45 years presenting with antibody-negative diabetic ketoacidosis post-recovery from COVID-19 pneumonia and to explore the potential for SARS-CoV-2 to adhere to human islet cells.
Methods: Explanted human islet cells from three independent solid organ donors were incubated with the SARS-CoV-2 spike protein receptor biding domain (RBD) fused to a green fluorescent protein (GFP) or a control-GFP, with differential adherence established by flow cytometry.
Results: Flow cytometry revealed dose-dependent specific binding of RBD-GFP to islet cells when compared to control-GFP.
Conclusions: Although a causal basis remains to be established, our case and in vitro data highlight a potential mechanism by which SARS-CoV-2 infection may result in antibody-negative type 1 diabetes.

Keywords: COVID-19; Critical Care; Diabetic Ketoacidosis; Islets of Langerhans; Pneumonia; SARS-CoV-2; Type 1 Diabetes.
 
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